Nutrition for Mental Disorders 3rd Year 2nd Semester Flashcards
Which of the following nutrients is commonly deficient in individuals with Generalized Anxiety Disorder (GAD)?
Choices:
a) Vitamin C
b) Vitamin B12
c) Magnesium
d) Vitamin A
c) Magnesium
Correct: Magnesium is one of the key nutrients commonly deficient in people with Generalized Anxiety Disorder (GAD). It helps regulate neurotransmitter activity, and low levels are associated with increased anxiety. Explanation:
a) Vitamin C
Incorrect: While Vitamin C is important for overall health, it is not commonly associated with GAD symptoms specifically. The deficiencies that most strongly affect anxiety disorders include B vitamins and magnesium.
b) Vitamin B12
Incorrect: While B12 deficiencies may impact mood and energy levels, B vitamins as a group, including B1, B6, and B12, are more commonly related to anxiety symptoms, but magnesium is the most relevant nutrient for GAD.
d) Vitamin A
Incorrect: Vitamin A is important for various bodily functions, but it is not typically linked to GAD. Deficiencies in B vitamins and magnesium have a stronger relationship with anxiety.
Anxiety – Magnesium
- Low magnesium can contribute to anxiety and chronic anxiety can also lower magnesium levels
- Study using multivitamin with 100mg of magnesium and a b complex showed improvements in anxiety scores
- IV magnesium in hospitalized patients significantly reduced anxiety and agitation
Which vitamin deficiency is commonly linked to Generalized Anxiety Disorder (GAD)?
a) Vitamin D
b) Vitamin B12
c) Vitamin A
d) Vitamin K
Correct Answer: a) Vitamin D
Explanation:
Vitamin D deficiency is commonly linked to Generalized Anxiety Disorder (GAD), among other nutrient deficiencies.
b) Vitamin B12 deficiency can contribute to mood disorders but is not as specifically linked to GAD.
c) Vitamin A is also relevant, but not as directly linked to GAD as vitamin D.
d) Vitamin K does not have a major association with GAD.
Vitamin D effect on Anxiety
- Vitamin D – Run 25 hydroxy vitamin D blood level to assess for deficiency
- Supplement to reach optimal dosing for 8-12 weeks and then re-assess level if it had been deficient
- Also good to assess magnesium, B12, folate and omega 3 fatty acids
Which of the following is NOT a common contributing factor to anxiety?
a) Sleep disturbances
b) Low progesterone
c) High fiber intake
d) Food sensitivities
✅ Correct Answer: c) High fiber intake
(c) Incorrect: High fiber intake does not contribute to anxiety—in fact, a diet rich in fiber supports gut health and may improve mood via the gut-brain axis.
Explanation:
(a) Correct: Poor sleep is a well-established contributor to anxiety as it disrupts cortisol regulation.
(b) Correct: Hormonal imbalances, such as low progesterone, can worsen anxiety symptoms, particularly in perimenopausal and menopausal women.
(d) Correct: Food sensitivities can lead to inflammation and stress, exacerbating anxiety symptoms.
Which of the following is an accurate statement regarding vitamin deficiencies and anxiety?
a) Vitamin D deficiency is uncommon in anxiety patients
b) Magnesium supplementation has shown no impact on anxiety
c) B vitamin supplementation may improve anxiety even in non-deficient individuals
d) Inositol is only beneficial for OCD and not for generalized anxiety
✅ Correct Answer: c) B vitamin supplementation may improve anxiety even in non-deficient individuals
(b) Incorrect: Magnesium plays a key role in anxiety, and supplementation has shown improvements in both mild and severe anxiety disorders.
Explanation:
(a) Incorrect: Vitamin D deficiency is common in anxiety patients, and testing 25-hydroxy vitamin D levels is recommended.
(c) Correct: Studies show that B vitamins (especially B12 and folate) can improve anxiety disorders even in individuals without a deficiency.
(d) Incorrect: While inositol is effective for OCD at high doses (15-20g/day), it also helps with generalized anxiety at lower doses (4-10g/day).
Why is blood sugar regulation important in anxiety management?
a) High blood sugar causes an immediate panic attack
b) Low blood sugar can trigger anxiety symptoms
c) High-protein diets are ineffective for managing blood sugar and anxiety
d) Eating irregular meals helps stabilize blood sugar
✅ Correct Answer: b) Low blood sugar can trigger anxiety symptoms; it leads to adrenaline and cortisol spikes, which can increase anxiety and panic-like symptoms.
Explanation:
(a) Incorrect: While high blood sugar is problematic, it is low blood sugar (hypoglycemia) that directly triggers symptoms like nervousness and rapid heart rate, mimicking anxiety.
(c) Incorrect: Adequate protein intake (0.8g/kg body weight/day) helps stabilize blood sugar, reducing fluctuations that can contribute to anxiety.
(d) Incorrect: Eating irregularly worsens blood sugar instability, which can exacerbate anxiety symptoms.
Blood sugars effect on Anxiety
- Low blood sugar can contribute to or cause anxiety
- Blood work – fasting blood sugar, fasting insulin, hemoglobin A1C
- Diet – adequate protein – minimum 0.8g/kg body weight/day
- Eat regular meals
- Minimize refined sugars and simple carbohydrates
- Work on increasing fiber to target 50g/day
How does caffeine impact anxiety?
a) Caffeine has no effect on anxiety
b) Caffeine reduces cortisol levels, calming the nervous system
c) Caffeine stimulates the nervous system and can contribute to anxiety symptoms
d) Caffeine withdrawal is not a concern when reducing intake
✅ Correct Answer: c) Caffeine stimulates the nervous system and can contribute to anxiety symptoms
(c) Correct: Caffeine is a known contributor to anxiety, and a 4-week caffeine-free trial is recommended to assess its impact.
Explanation:
(a) Incorrect: Caffeine is a stimulant that can worsen anxiety symptoms in sensitive individuals.
(b) Incorrect: Caffeine increases cortisol levels, leading to heightened stress responses.
(d) Incorrect: Caffeine withdrawal can cause headaches and irritability, which is why gradual reduction is recommended.
Caffeine effect on Anxiety
- Caffeine for some patients will contribute to their anxiety as can other stimulants
- Doing a 4 week caffeine free trial will help determine if this is a contributor
- If patient is consuming a lot of caffeine start with reducing the amount by ½
every 4 days to minimize withdrawal symptoms
- Can also try to initially switching some coffee to green tea as this also has theanine which can be calming
- Need to do full elimination trial with no caffeine to properly assess if caffeine is
a contributor
What role do fermented foods and probiotics play in anxiety?
a) They increase GABA and serotonin production in the gut
b) They reduce norepinephrine levels in the brain
c) They cause inflammation, worsening anxiety symptoms
d) They are only beneficial for digestive issues, not anxiety
✅ Correct Answer: a) They increase GABA and serotonin production in the gut
(a) Correct: The gut produces a significant amount of neurotransmitters, including GABA and serotonin, which regulate mood and anxiety.
Explanation:
(b) Incorrect: While gut health is important, fermented foods and probiotics do not directly lower norepinephrine in the brain.
(c) Incorrect: Fermented foods reduce inflammation, supporting gut and mental health.
(d) Incorrect: Probiotic supplementation has been shown to improve anxiety and insomnia, not just digestion.
What is the mechanism of action of L-theanine in anxiety management?
a) It blocks the production of cortisol
b) It enhances GABA, serotonin, and dopamine release
c) It reduces blood sugar, stabilizing mood
d) It acts as a stimulant, increasing mental alertness and anxiety
✅ Correct Answer: b) It enhances GABA, serotonin, and dopamine release
(b) Correct: L-theanine boosts GABA, serotonin, and dopamine, promoting relaxation without sedation.
Explanation:
(a) Incorrect: L-theanine does not block cortisol, but it does reduce cortical neuron excitation.
(c) Incorrect: While inositol helps with blood sugar, L-theanine acts on neurotransmitters rather than glucose metabolism.
(d) Incorrect: Unlike caffeine, L-theanine reduces stress and anxiety while promoting mental clarity.
How does Vitamin B help improve anxiety even in non-deficient individuals?B vitamin supplementation can improve anxiety even in non-deficient individuals because B vitamins play a critical role in neurotransmitter synthesis, stress regulation, and brain function. Here’s why:
The specific ones that help are (Anxiety – B vitamins
- Treatment with B vitamins has shown improvement in anxiety disorders even without a deficiency
- Focus on B12 and folate but full b complex can be helpful
)
- Role in Neurotransmitter Production
B6 (Pyridoxine) helps synthesize serotonin, dopamine, and GABA—all of which regulate mood and anxiety. Even in people without a deficiency, additional B6 can enhance neurotransmitter function, improving anxiety symptoms.
B12 and Folate (B9) are crucial for methylation, a process involved in the production of dopamine and serotonin. Poor methylation can contribute to anxiety, even if lab levels are normal. - B Vitamins Reduce Homocysteine Levels
High homocysteine (an amino acid linked to stress and inflammation) is associated with increased anxiety and depression.
B12, B6, and folate lower homocysteine, reducing the risk of anxiety-related neurological dysfunction.
- B Vitamins Support the Stress Response
B vitamins help regulate the hypothalamic-pituitary-adrenal (HPA) axis, which controls the body’s response to stress.
Studies show that B vitamin supplementation reduces stress and anxiety in both deficient and non-deficient individuals. - Clinical Evidence
A 2022 systematic review found that B-complex supplementation reduced anxiety symptoms even in people with normal B-vitamin levels.
A study using B-vitamin supplementation for workplace stress showed significant reductions in anxiety and depression, regardless of baseline nutrient status.
Bottom Line
Even if someone is not clinically deficient, supplementing with B vitamins can enhance neurotransmitter production, reduce stress-related inflammation, and support brain function, leading to reduced anxiety.
What are the common nutrient deficiencies for people with Anxiety?
- Generalized anxiety disorder:
- Vitamin A
- Vitamin C
- Vitamin D
- Vitamin E
- B vitamins
- Magnesium
Things that can effect Anxiety are caffeine which increases it, fermented foods and probiotics (SCFA) help, GABA (inhibitory) to lessen anxiety, Inositol sensitizes hormones to respond better to medications and regulates blood sugar, L-theanine decreases anxiety, Magnolia lessens anxiety, Passionflower is a nervine a well known anxiolytic, Omega 3’s inhibits anxiety
How do fermented foods and probiotics help with anxiety?
A) They help restore gut microbiome balance, which influences neurotransmitter production.
B) They provide direct GABA supplementation to the brain.
C) They act as a sedative, directly calming the nervous system.
D) They increase the production of adrenaline, helping with stress response.
A) Correct – Fermented foods and probiotics support a healthy microbiome, which aids in neurotransmitter production (GABA, serotonin) and improves gut-brain communication.
Answer Explanations:
B) Incorrect – While GABA is produced in the gut, fermented foods do not provide GABA directly to the brain.
C) Incorrect – Probiotics and fermented foods do not work like sedatives; they support long-term gut health and neurotransmitter balance.
D) Incorrect – Increasing adrenaline would increase stress, not reduce anxiety.
Fermented foods and Probiotics effects on Anxiety
- Intestinal dysbiosis can play a contributing role in anxiety
- Gaba and serotonin are both made in the intestinal tract so concerns in the digestive system can reduce production
- Eating a diet rich in fermented foods and fiber will aid the short chain fatty acid production to support a healthy microbiome
- Probiotic supplementation with a multi-strain approach has good research helping anxiety and insomnia
What is the role of GABA in anxiety management?
A) It is an excitatory neurotransmitter that increases brain activity.
B) It is an inhibitory neurotransmitter that helps balance excitatory signals.
C) It is a hormone that regulates stress levels.
D) It is a mineral essential for nerve function.
B) Correct – GABA helps reduce overactivity in the brain, which can contribute to anxiety, restlessness, and insomnia.
Answer Explanations:
A) Incorrect – GABA is not excitatory; it is inhibitory, meaning it calms brain activity.
C) Incorrect – GABA is a neurotransmitter, not a hormone.
D) Incorrect – GABA is not a mineral; it is a chemical messenger in the nervous system.
GABA effects on Anxiety
- Gaba is a major inhibitory neurotransmitter in the central nervous system as it helps balance excitatory neurotransmitters
- Deficiency can contribute to anxiety, depression, insomnia
- Gaba supplementation can help symptoms of anxiety, restlessness, insomnia
- Can increase time spent in deep sleep by 20%
- Supplementing dose 300-900mg/day
What is the recommended dose of inositol for generalized anxiety?
A) 300-900mg/day
B) 4-10g/day
C) 80-160mg/day
D) 15-20g/day
B) Correct – 4-10g/day of inositol has been shown to help with generalized anxiety and blood sugar regulation.
Answer Explanations:
A) Incorrect – This is the recommended dose for GABA, not inositol.
C) Incorrect – This is the dose range for oral lavender supplements.
D) Incorrect – While inositol doses of 15-20g/day may help with OCD and panic disorders, this is not the typical dose for generalized anxiety.
**Inositol for Anxiety; Inositol has a very high safety profile for patients **
- Dosing 4-10g/day can be helpful for generalized anxiety and assisting with blood sugar regulation
- At high doses 15-20g/day there has been improvements seen with OCD and panic disorders
- Inositol helps to sensitize hormone and neurotransmitter receptor sites so can aid in medications becoming more effective
Which statement about lavender’s effect on anxiety is true?
A) Lavender oil is only effective when applied topically.
B) Oral lavender has been compared to anxiety medications with similar benefits.
C) Lavender works by blocking serotonin receptors.
D) Lavender is only effective in children, not adults.
Answer Explanations:
B) Correct – Studies have compared oral lavender to paroxetine and lorazepam, showing similar effectiveness for anxiety and agitation.
A) Incorrect – Lavender can be used as aromatherapy or orally; its effects are not limited to topical application.
C) Incorrect – Lavender does not block serotonin receptors; instead, it has calming and anxiolytic effects.
D) Incorrect – Lavender has shown effectiveness in both adults and children.
How does L-theanine help with anxiety and stress?
A) It increases GABA, serotonin, and dopamine levels.
B) It lowers stress by blocking adrenaline production.
C) It acts as a sedative, making people drowsy.
D) It prevents anxiety by increasing heart rate.
Answer Explanations:
A) Correct – L-theanine is involved in the formation of GABA and stimulates serotonin and dopamine release, improving relaxation and mood.
B) Incorrect – L-theanine reduces stress but does not completely block adrenaline production.
C) Incorrect – L-theanine is non-sedating and does not cause drowsiness.
D) Incorrect – Increasing heart rate would likely increase anxiety, not reduce it.
Why might magnolia bark be preferred for daytime anxiety relief?
A) It has a stimulating effect that increases alertness.
B) It is non-sedating, so it can be used during the day.
C) It is a prescription medication that requires a doctor’s approval.
D) It lowers blood pressure significantly, causing drowsiness.
L-theanine effect on Anxiety
- Amino acid that can cross the blood brain barrier and is rapidly absorbed
having effect within 30 minutes
- Studies demonstrate can improve both anxiety and sleep disorders
- Study looking at impact of L-theanine on stress – 200mg dosed as start and again in the middle of stressful task and theanine reduced cortical neuron excitation
- Trial using 200mg/day for 4 weeks saw improvement in stress, anxiety, depression and sleep concerns. Patients report requiring less sleep medication
- Improved mental alertness and increases alpha brain wave activity
- Involved in the formation of Gaba and stimulated release of serotonin and dopamine
Why might magnolia bark be preferred for daytime anxiety relief?
A) It has a stimulating effect that increases alertness.
B) It is non-sedating, so it can be used during the day.
C) It is a prescription medication that requires a doctor’s approval.
D) It lowers blood pressure significantly, causing drowsiness.
B) Correct – Magnolia bark is non-sedating, making it a good option for daytime use.
Answer Explanations:
A) Incorrect – Magnolia bark does not act as a stimulant; it primarily helps with anxiety and depression.
C) Incorrect – Magnolia bark is available as a supplement and does not require a prescription.
D) Incorrect – While it may have calming properties, it does not cause significant drowsiness or blood pressure drops.
What did studies find when comparing passionflower to oxazepam for anxiety?
A) Passionflower was less effective than oxazepam, with fewer side effects.
B) Passionflower and oxazepam were equally effective, but passionflower had fewer side effects.
C) Passionflower caused more drowsiness than oxazepam.
D) Passionflower was only effective when combined with oxazepam.
B) Correct – Studies found similar effectiveness between passionflower and oxazepam, but passionflower had fewer side effects, such as impaired work performance.
Answer Explanations:
A) Incorrect – Passionflower was not less effective than oxazepam.
C) Incorrect – Passionflower did not cause drowsiness like oxazepam.
D) Incorrect – Passionflower was effective on its own, not only when combined with oxazepam.
Passionflower effects on Anxiolytics
- Passionflower is well known for its anxiolytic properties
- May work by increasing Gaba currents in hippocampal regions
- Randomized trial compared 45 drops of passionflower extract to 30mg oxazepam for 1 month showed similar benefit for anxiety
- Passionflower group did not have any side effects, oxazepam some patients had impaired work performance
What was the key finding from the meta-analysis of Omega-3s and anxiety?
A) Omega-3s had no effect on anxiety disorders.
B) Omega-3s were more effective in people with clinical anxiety disorders than in subclinical populations.
C) Omega-3s only helped with depression, not anxiety.
D) Omega-3 supplementation increased stress hormone levels.
B) Correct – The study found that Omega-3s had a stronger anxiolytic effect in people with clinical anxiety disorders than in those with mild or subclinical anxiety.
Answer Explanations:
A) Incorrect – The meta-analysis showed a clear benefit of Omega-3s for anxiety.
C) Incorrect – Omega-3s have been shown to benefit both depression and anxiety.
D) Incorrect – Omega-3s do not increase stress hormones; instead, they have a calming effect.
Which of the following is a key diagnostic criterion for Major Depressive Disorder?
A) Depressed mood or loss of interest in activities for more than 2 weeks
B) Occurs only in older adults with chronic diseases
C) Must include all 9 depressive symptoms
D) Symptoms must last for at least 6 months
A) Correct – Major Depressive Disorder (MDD) is diagnosed when a person has a depressed mood or loss of interest in activities for more than 2 weeks, along with impaired function.
Answer Explanations:
B) Incorrect – Late-life depression is associated with older adults and chronic disease, but MDD can occur at any age.
C) Incorrect – A person must experience at least 5 out of 9 depressive symptoms, not all 9.
D) Incorrect – The minimum duration for MDD is 2 weeks, not 6 months.
Which nutrient deficiencies are linked to depressive disorders?
A) B vitamins, magnesium, iron, zinc, vitamins A, C, D
B) Only vitamin B12
C) Only vitamin C and iron
D) High carbohydrate intake
Answer Explanations:
A) Correct – Deficiencies in B vitamins (B1, B6, B9, B12), minerals (magnesium, iron, zinc), and vitamins A, C, and D can contribute to depression.
B) Incorrect – B12 is important, but multiple nutrients are involved in depression.
C) Incorrect – While vitamin C and iron are essential, many other nutrients also play a role.
D) Incorrect – High carbohydrate intake may impact mood, but this is not a deficiency-related issue.
How does curcumin help with depression?
A) It is a stimulant that increases dopamine release.
B) It has anti-inflammatory effects and can be combined with antidepressants.
C) It replaces the need for antidepressant medications.
D) It only works for young adults.
B) Correct – Studies show curcumin has anti-inflammatory effects and can be used with antidepressants or as a standalone treatment.
Answer Explanations:
A) Incorrect – Curcumin does not act as a stimulant but works through anti-inflammatory pathways.
C) Incorrect – Curcumin can support treatment but does not replace prescribed antidepressants.
D) Incorrect – The benefits of curcumin were strongest in middle-aged people but are not limited to that group.
Curcumin for Depressive Disorders
- Review article of 7 trials looked at the use of curcumin in depression
- Dosing ranged 500-1500mg/day and some combined with
pharmaceuticals others as stand-alone treatment
- Trials went for 5-12 weeks
- 6/7 trials showed a positive benefit – one that didn’t was 5-week trial that combined with an antidepressant
- Sub-group analysis found highest impact on depressive symptoms in
middle-aged people using higher doses for longer periods of time
Reference
Lopresti AL. Potential Role of Curcumin for the Treatment of Major Depressive Disorder. CNS Drugs. 2022 Feb;36(2):123- 141. doi: 10.1007/s40263-022-00901-9. Epub 2022 Feb 7. PMID: 35129813; PMCID: PMC8863697.
Which diet is most researched for its benefits on depression?
A) The Mediterranean diet
B) A high-sugar diet
C) A diet low in fats and proteins
D) A zero-carb diet
Answer Explanations:
A) Correct – The Mediterranean diet has been extensively studied for its benefits in managing depression, as it is rich in essential nutrients and omega-3s.
B) Incorrect – A high-sugar diet can contribute to mood instability rather than help depression.
C) Incorrect – Adequate protein intake is necessary for neurotransmitter production.
D) Incorrect – Carbohydrates, particularly whole grains, play an important role in maintaining stable blood sugar and mood.
Mediterranean Diet effect on depression
- Most researched diet for depression is the Mediterranean diet
- Need to ensure adequate protein intake – 0.8-1.2g/kg body weight
- Nutrient dense with goal of 5-10 servings of fruits and vegetables/day
- Focus on fish in diet to both reduce inflammation and increase omega 3 fatty acids
- Healthy fats – olive oil, fish, avocado, nuts, seeds
- Combination of lean proteins and vegetarian sources of protein
- Ensure good glycemic control – so minimize simple and refined sugars with
focus on whole grains
Which statement about magnesium and depression is correct?
A) Higher serum magnesium levels are linked to lower depressive symptoms.
B) Only dietary magnesium intake reduces depression.
C) Magnesium is unnecessary for mental health.
D) Magnesium is only beneficial for sleep, not depression.
A) Correct – Studies show that higher serum magnesium levels are associated with lower depressive symptoms.
B) Incorrect – Dietary magnesium intake alone showed no direct association with depression reduction.
C) Incorrect – Magnesium plays a role in neurotransmitter function and mood stabilization.
D) Incorrect – While magnesium can help with sleep, it also influences mood and anxiety.
Magnesium effects on Depression
- Higher serum magnesium levels were associated with lower depressive scores and a lower risk of depressive symptoms
- dietary magnesium intake showed no association.
- Patients with serum magnesium <0.75 mmol/L, compared to those with ≥0.85 mmol/L had lower depressive scores
